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ol�afv SAN JOAQUIN COUNT <br /> �pR .CSG <br /> p ?� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 i <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.orglehd <br /> cq{iFd'R`'� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Date: 7,1 rd <br /> e of Facility: s! . <br /> ess: City: Zip Code: <br /> 3 � Telephone: <br /> erlOperator: <br /> Program Element: I ZL 3 Program Record: [)j I inspection Type:; l�,( <br /> B180 Posted D Yes D Rermit Posted D Yes D P Re-Inspection on or After: <br /> IN=In Compliance NIO=Not Observed NIA=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance <br /> See reverse side for code sections and general requirements that correspond to each violation listed below. <br /> Major violations ose a threat to public health and must be corrected immediatel . Non-compliance ma warrant closure of the food facility <br /> • <br /> tv <br /> 1. Demonstration of knowledge;food 24. Person In Charge Is present and performs duties <br /> ' Communicable disease;reporting, 25. Personal cleanliness and hair restraints <br /> _ <br /> 3. No discharge from eyes,nose,or mouth;no open wounds -,. R tae►#1lh <br /> "..,... <br /> Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> 7. Food protected from contamination during storage <br /> Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> y_ <br /> Handwasfiing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used <br /> Proper hot and cold holding temperatures 30. Food storage food storage containers labeled <br /> Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided <br /> 32. Food properly labeled and honestly presented <br /> Proper cooling methods 1 <br /> IE <br /> 10. Proper cooking time and temperatures �:� �° <br /> 1 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> �� 3 Warewashing facilities maintained;test strips available <br /> tkl .`- 4. <br /> i <br /> 12. No re-service ofreturnedfood ',- 35. Equipment/utensils approved;installed;clean;good repair <br /> I <br /> 13- Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use <br /> f <br /> 14. Food contact surface cleaned and sanitizedlwarewashing procedures 37. Vending machines maintained <br /> '" " �„ 38- Approved and sufficient ventilation and lighting <br /> �. <br /> AA 5. Food obtained from approved source �' 39. Thermometers provided,accurate,and easily visible <br />{ 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations4 <br /> 1 Plumbing ma ntained;proper back flow prevention <br /> 18 Compliance with HACCP plan or vari 42. Garbage and refuse properly disposed <br /> r3. Toilet facilities clean,supplied,and maintained <br /> 19. Advisory provided for raw or underco 44. Premises;personallcleaning items;vermin-proofing <br /> _ <br /> a <br /> 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> 6. No living or sleeping quarters inside facility <br /> 01, <br /> 1.Hot and cold potable water available. `�° o = ' <br /> 7. Signs posted;last inspection report available <br /> 2. Sewagelwastewater properly disposed;toilet facility useable 8. Compliance with plan review requirements <br /> 9. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> Received BylTitle: , ) _! G -3�I f V+} <br /> v t-/�7 <br /> L �'- CROP <br /> EH Specialist: u ,. 1 Phone: f �_ Page 1 of <br /> FOOD PROGRAM OIR <br /> EHD 16-23 (1sl pg) 4012 V �C <br />